- Earlier onset and longer duration of adversity most consistently associate with structural alterations in limbic and paralimbic regions, notably hippocampus, amygdala and cerebellum.
- Evidence for discrete sensitive periods is mixed, varying by brain system, outcome and analytic approach, and functional neuroimaging studies are comparatively limited.
- Reconceptualise sensitive periods as probabilistic, system specific and shaped by adversity nature, timing and chronicity; integrate longitudinal neurobiological measures to inform interventions.
J Child Psychol Psychiatry. 2026 Oct 27. doi: 10.1111/jcpp.70259. Online ahead of print.
ABSTRACT
It is proposed that adverse childhood experiences (ACEs) – potent predictors of mental illness – exert time-dependent effects on neurodevelopment, reflecting periods of heightened neuroplasticity and developmental sensitivity. We systematically reviewed neuroimaging studies examining the role of timing in the association of ACE exposure with brain structure and function across the lifespan. Across 43 studies spanning childhood to adulthood, findings most consistently implicate earlier onset and longer duration of adversity in alterations to limbic and paralimbic regions, including the hippocampus, amygdala, cerebellum and global brain measures. However, evidence for discrete sensitive periods is mixed and varies by brain system, outcome and analytic approach, with no consistent pattern of sensitive periods emerging across adversity types and functional neuroimaging studies remaining comparatively limited. Progress in the field is further constrained by substantial conceptual and methodological heterogeneity, including inconsistent operationalisation of sensitive periods, reliance on retrospective ACE measures and predominantly cross-sectional designs. Moving forward, we argue that advancing the field will require reconceptualising sensitive periods as probabilistic, system-specific and shaped by the nature, timing and chronicity of adversity, rather than as fixed developmental windows. Integrating longitudinal assessment of adversity and neurodevelopment with measures of the neurobiological processes underlying plasticity may help determine whether sensitive periods are better characterised by underlying neuroplasticity than chronological age alone. Improved understanding of these developmental processes may ultimately help inform the timing and targeting of preventive and therapeutic interventions for young people exposed to adversity.
PMID:42946537 | DOI:10.1111/jcpp.70259
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